Skip to main content

Table 1 Pearls and pitfalls

From: Beyond broken spines–what the radiologist needs to know about late complications of spinal cord injury

Organ system Pearls Pitfalls
GU Pseudohydronephrosis defined as a focal enlargement of the urinary tract can usually be distinguished from urinary obstruction on CT because it lacks asymmetric fat stranding, unilateral ureter dilatation and unilateral renal enlargement* Self-catheterisation or urological instrumentation can introduce gas in the collecting system and carful clinical history allows differentiation from pyelitis
GI   Obtain abdominal imaging early for non-specific symptoms such as nausea, anorexia or autonomic dysreflexia to avoid delayed diagnosis of cholecystitis and pancreatitis
Cardiovascular CAD and PE imaging results in SCI patients are similar to those in the general population SCI increases the risk for coronary artery disease (CAD) and pulmonary embolus (PE)
Neuro   SCI increases the incidence of peripheral neuropathy. Neuropathic arthropathy of the spine can have imaging features similar to infection. Aspiration and culture may be necessary to distinguish
Bone and soft tissue Reliable distinction of cellulitis from abscess formation requires the administration of contrast media on CT and MR. Abscess will typically show rim enhancement around a central non-enhancing fluid collection Lower extremity joint effusions seen in SCI patients may be aseptic or infectious. Spinal hardware radiographs should be carefully compared to prior imaging to detect loosening and failure
  1. *Source: Gunn ML, ed. Pearls and Pitfalls in Emergency Radiology, Cambridge Medicine, 2013